Healthcare Provider Details

I. General information

NPI: 1205752854
Provider Name (Legal Business Name): MICHELLE NIELAND PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2026
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 RILEY HOSPITAL DR
INDIANAPOLIS IN
46202-5109
US

IV. Provider business mailing address

11533 LOCH RAVEN CT
FISHERS IN
46037-4188
US

V. Phone/Fax

Practice location:
  • Phone: 317-944-2143
  • Fax: 317-944-3107
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0200X
TaxonomyPediatric Pharmacist
License Number26031280A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: